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Practical assessment of different saw types for field amputation: A cadaver-based study
Dominik A Jakob1, Michael Minneti1, Elizabeth R Benjamin1
1Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County + University of Southern California Medical Center, University of Southern California, Los Angeles, CA 90033, USA.
The American Journal of Emergency Medicine
|March 1, 2021
Summary
The oscillating saw is the ideal tool for rapid field amputations, outperforming other saws. Amputating through bone is significantly faster than through a joint.
Area of Science:
- Surgical Extrication
- Trauma Surgery
- Emergency Medicine
Background:
- Field amputations are life-saving procedures for entrapped patients.
- These procedures require speed, limited equipment, and minimal provider risk in austere environments.
Purpose of the Study:
- To identify the optimal saw for field amputations.
- To determine whether through-bone or through-joint amputation is faster.
Main Methods:
- Prospective cadaver study comparing four saws (Gigli, manual pruning, electric oscillating, electric reciprocating) for through-bone amputation.
- Evaluated amputation time, saw seating attempts, slippage, bone cut quality, body fluid splatter, and space requirements.
- Compared the best through-bone saw with scalpels, scissors, and the oscillating saw for through-joint amputations.
Main Results:
- Reciprocating and oscillating saws were fastest for through-bone amputation (2.1 and 3.0 seconds, respectively).
- The oscillating saw demonstrated superior or equivalent performance in bone cut quality, space requirements, and ease of use.
- Through-joint amputations (125.0–125.5 seconds) were significantly slower than through-bone amputations.
Conclusions:
- The oscillating saw is ideal for field amputations due to its speed, precision, safety, and space efficiency.
- A Gigli saw serves as a reliable backup when electric tools are unavailable.
- Through-bone amputation is a faster method than through-joint amputation in emergency scenarios.
